1. MedPix Medical Image Database COW - Case of the Week Case Contributor: Steven J Goldstein Affiliation: University of Kentucky

2. MedPix No: 13481 - History Pt Demographics: Age = 37 y.o. Gender = woman 37 year old woman with longstanding diagnosis of Langerhans cell histocytosis presents now with hypopituitarism. Prior skeletal surveys reveal lesions in the left femoral neck and vertebra plana deformity of L4. Chest film also shows intersitial lung diseae. Downloaded by (-1)

3. MedPix No: 13481 - EXAM & LABS Not available

4. Langerhans Cell Histiocytosis, Pituitary stalk 7 mm enhancing mass pituitary infundibulum producing optic chiasmatic compression. Downloaded by (-1)

5. Langerhans Cell Histiocytosis with Infundibular Mass There is a 7 mm enhancing mass on the pituitary infundibulum producing optic chiasm compression. Downloaded by (-1)

6. Langerhans Cell Histiocytosis with Infundibular Mass There is a 7 mm enhancing mass on the pituitary infundibulum producing optic chiasm compression. Downloaded by (-1)

7. Langerhans Cell Histiocytosis with Infundibular Mass There is a 7 mm enhancing mass on the pituitary infundibulum producing optic chiasm compression. Downloaded by (-1)

8. Langerhans Cell Histiocytosis with Infundibular Mass There is a 7 mm enhancing mass on the pituitary infundibulum producing optic chiasm compression. Downloaded by (-1)

9. Langerhans Cell Histiocytosis with Infundibular Mass There is a 7 mm enhancing mass on the pituitary infundibulum producing optic chiasm compression. Downloaded by (-1)

10. Langerhans Cell Histiocytosis with Infundibular Mass There is a 7 mm enhancing mass on the pituitary infundibulum producing optic chiasm compression. Downloaded by (-1)

11. FINDINGS 7 mm enhancing mass pituitary infundibulum with secondary optic chiasm compression.

12. DIFFERENTIAL DIAGNOSIS What is your Differential Diagnosis? Rathke*s cleft cyst - Pituitary adenoma - Craniopharyngioma - Germinoma - Langerhan cell histiocytosis

13. Diagnosis: Langerhans Cell Histiocytosis Dx Confirmed by: Imaging and clinical history

14. DISCUSSION